A lower-than-hoped-for number of residency-interview invitations doesn’t mean it’s time for an applicant to panic. It does indicate that it is time for a residency applicant to examine contingency plans. Those plans could include pursuing a preliminary position or preparing to participate in the Supplemental Offer Assistance Program (SOAP).
For medical students whose low-interview count is driving anxiety over not matching, understanding these pathways—why some experts tout them and the data behind pursuing them—can help them make informed plans and decisions.
What interview totals mean
Interview totals are not destiny, but they are one of the clearest signals applicants have that they may need to expand their strategy. The convention, historically, has been that applicants should have roughly a dozen interviews to feel good about their chances of matching.
Looking at recent data on Match rank-order list length—a rough proxy for the significance of interview invitation totals because applicants generally rank most, if not all, of the programs with which they interview—illustrates how limited options can shape Match outcomes.
The most recent available data compiled by the National Resident Matching Program (NRMP) shows that in the 2024-25 residency-selection cycle, applicants who were placed through the Match algorithm had an average rank-order list of 12 programs. That is compared with an average of 6.3 for those who secured a SOAP position and 3.5 for those who did not match.
The prelim route
For residency applicants whose interview totals remain low—particularly specialties considered to be highly competitive—submitting additional applications to preliminary programs can yield results.
Most Match positions are categorical—beginning at intern year and offering the full course of residency training required for board certification in a specialty. Conversely, preliminary programs typically span the first year of graduate medical education (GME) training and are followed by training in an advanced program, which spans the remainder of your training. The most common PGY-1 only tracks are in general surgery and internal medicine.
While the ideal outcome is for residency applicants to match in preliminary and advanced programs in tandem, that is not always the case. In the 2024-25 cycle 3.8% of residency applicants secured only a preliminary position while 5.2% landed both a preliminary and advanced position.
Applicants who match in only a preliminary track will have to apply to advanced positions in the next cycle to continue their training. Still, a year spent in medicine rather than a year spent waiting on the sidelines has many benefits, according to Mark Meyer, MD.
“In my view, securing a residency position and continuing clinical training may be the best way to strengthen your competitiveness,” said Dr. Meyer. As senior associate dean for student affairs at the University of Kansas (KU) School of Medicine, he advises medical students on the Match.
The prospect of landing a preliminary position later in the residency-selection calendar offers better opportunity than a late application to a categorical position. Dr. Meyer highlighted that in certain instances applicants can secure a preliminary position without an interview.
The University of Kansas School of Medicine is a member of the AMA UME Curricular Enrichment Program, which helps medical schools strengthen undergraduate medical education by providing interactive modules that assist students in distinguishing themselves in residency and beyond. Developed by experts in medical education, the program supports evolving educational needs through customizable curriculum and streamlined progress and reporting tools for administrators. Learn more.
SOAP offers a fresh opportunity
SOAP is a vehicle through which eligible unmatched and partially matched applicants in the Main Residency Match apply for and are offered positions that were not filled when the matching algorithm was initially processed.
SOAP has proven effective. In 2025, Match rates for senior applicants who submitted rank-order lists from U.S. MD- and DO-granting medical schools were higher than 97%. Among applicants who were eligible for SOAP in 2025, 57% of U.S. DO seniors and 44% of U.S. MD seniors applied for and accepted positions.
If interview totals are low, residency applicants should not assume they will end up in SOAP. But Dr. Meyer’s advice is that applicants “definitely need to keep an open mind” about matching through SOAP.
On Monday morning of Match Week—March 15 for the 2026–2027 residency selection—all applicants learn whether, but not where, they matched. The SOAP process begins the following day.
“SOAP moves quickly,” said Dr. Meyer, an AMA member. "It helps to have an initial game plan.”
Practical steps include engaging your medical school’s office of student affairs in the process early, identifying trusted specialty-specific advisers, reviewing programs in advance, assessing where the greatest opportunity for placement through SOAP exists and deciding what additional specialties you may consider.
“You really do have to weigh what’s realistic with your long-term goals,” he said. “Are you going to put your eggs in one basket and apply to what might be one or two spots that may be open in ortho, or am I going to do a quick turn and move towards radiology or anesthesia or primary care?”
For residency applicants pursuing the most competitive fields, that pivot can be tricky. But changing courses, Dr. Meyer said, hardly means your career will not be satisfying and fulfilling.
“There are hundreds of equally—if not more—talented and qualified individuals in their own right, applying for a finite number of positions,” he said. “Highly talented and qualified people don’t end up in certain specialties just due to that supply-and-demand phenomenon.”
